The Provider’s Billing Deadline: 35 Days

Under Florida PIP rules, medical providers must submit their bills within 35 days of the date of service, unless they qualify for the extended 75-day timeframe.

This 35-day deadline is strict for providers who do not submit an NIT.

Bill submitted within 35 days → Claim is valid

Bill submitted after 35 days → Insurer may deny as “untimely”

Because many clinics batch-bill or run behind after busy weeks, this deadline catches providers off-guard.

2. How Providers Can Extend the Deadline to 75 Days

Florida law allows medical providers to extend their billing window from 35 days to 75 days, BUT ONLY if the provider sends a Notice of Initiation of Treatment (NIT) within 21 days of the patient’s very first treatment date.

This is the most important timing rule for provider billing.

3. Understanding the Notice of Initiation of Treatment (NIT)

The NIT is a simple notice sent to the insurer stating that:

  • You began treating the patient
  • On a specific date
  • For injuries related to the motor vehicle accident

The statute does not require detailed records—just timely notice.

4. The 21-Day Rule for Sending the NIT

To qualify for the 75-day extended billing window:

The NIT must be sent within 21 days of the patient’s first date of treatment.

This applies only to the initial treatment—not every subsequent visit.

Examples:

  • First visit: May 1
  • NIT deadline: May 22
  • Billing window: 75 days from date of service

If a clinic sends the NIT late—even by one day—the 75-day extension is not available.

5. How the 75-Day Billing Window Helps Clinics

The extended billing period gives providers more flexibility, especially those who:

  • Bill monthly
  • Submit claims in batches
  • Experience coding or documentation delays
  • Need more time to process complex treatment plans
  • Are busy with high patient volume

With the NIT properly submitted:

Bills may be submitted up to 75 days after the date of service

Insurers must still follow the 30-day rule after receiving the claim

Providers reduce the risk of denials due to “untimely submission”

This simple step can protect thousands of dollars in otherwise lost reimbursement.

6. Why Many Clinics Miss This Requirement

Common reasons providers miss the 21-day NIT deadline:

  • Staff not trained on PIP timelines
  • Billing teams unaware of the extended 75-day option
  • Patients delaying paperwork
  • Busy clinics batching bills weeks later
  • Intake not confirming correct accident date
  • Misunderstanding that the rule applies to the first treatment date, not later dates

Training intake staff on this timeline prevents most of these issues.

7. Practical Steps for Clinics

A. Ask intake patients:

“When was the accident?”
This determines timing immediately.

B. Log the first treatment date clearly

This date controls the 21-day NIT deadline.

C. Submit the NIT the same day the patient first visits

Most clinics handle this electronically.

D. Track NIT submissions in a simple spreadsheet or EHR note

E. Educate billing staff on the difference between:

  • 35-day billing rule
  • 75-day extended billing rule
  • 30-day insurer payment rule

This eliminates the majority of avoidable denials.


Disclaimer: This content is general educational information and is not legal advice. Coverage determinations depend on policy terms and factual circumstances.

Tagged: